《孫真人備急千金要方》Vol. 30

Essential Prescriptions Worth a Thousand Gold Pieces by the Perfected Sun, Volume 30 (the original text gives the volume number as “Qie Eleven”)

Edited and collated by Lin Yi and others, Court Gentleman of the Song dynasty, Acting Junior Minister of the Court of Imperial Sacrifices, and Collator of the Secret Pavilion

Prescriptions for Cold Damage

Third Prescription for Cold Damage Plasters

Green Plaster: Used to treat headache, stiffness of the neck and nape, and troublesome pain in the limbs caused by cold damage.

Angelica sinensis, Sichuan lovage rhizome, Sichuan pepper, dahurian angelica root, evodia fruit, aconite, monkshood, and licorice, three liang each.

Coarsely cut the eight ingredients (the term “fuju” means to cut medicinal ingredients into small pieces), and soak them for two nights in strong bitter wine—that is, vinegar. Add four jin of lard and simmer until the ingredients turn yellow, then strain out the dregs. Take with warm wine, using an amount of plaster the size of three date pits each time, three times a day, until sweating occurs. If there is no response, the dose may be increased slightly. The plaster may also be rubbed onto the body.

If, on the first day of cold damage, the headache is severe and the back is stiff, rubbing with this plaster is especially effective.

Yellow Plaster: Used to treat fever, a flushed complexion, headache, and stiffness of the neck and nape in cold damage. It is also used for conditions known as “thief wind” and “roaming wind.”

Rhubarb, aconite, asarum, dried ginger, Sichuan pepper, and cassia bark, half a liang each; fifty croton seeds.

Coarsely cut the seven ingredients and soak them overnight in strong bitter wine. Take one jin of lard from the twelfth lunar month, then simmer the mixture over a controlled flame, bringing it to a boil and removing it from the heat three times. The plaster is then ready.

For cold damage with a flushed face and fever, take one pill the size of a parasol tree seed with wine. Alternatively, warm the plaster over a fire and rub it over the body several hundred times. This prescription also treats “thief wind.” It is said to work especially well for conditions in which wind pathogens move through the skin: wherever symptoms occur, rub the plaster there. This is a highly valued prescription belonging to Zhao Quan.

White Plaster: Used for headache in cold damage. Rub the body facing a fire, then take one pill the size of an apricot kernel with wine. Cover the body warmly to induce sweating. Rub the body a thousand times for the medicine to take effect. This plaster is also used for malignant sores, sores on children’s heads, and sores on the necks of cattle or beneath horses’ saddles. First wash the sores with salt water and dry them with a cloth, then apply the plaster. For abscesses and swellings, warm the plaster over a fire and rub it a thousand times, twice daily; the swelling will subside on its own.

Monkshood, aconite, Japanese star anise, and Chinese azalea, three liang each.

Coarsely cut the four ingredients and soak them overnight in three sheng of bitter wine. Set up an open-air stove facing east, then make twelve piles of damp earth, each about one sheng in size. Put three jin of refined lard in a bronze vessel and place it over the stove. Use reeds as fuel. When the lard has melted, add the soaked ingredients and bring the mixture to a boil, then set the bronze vessel on one of the earth piles. Once the liquid stops boiling… [the original text ends here]

Repeat this twelve times, as before, so that the medicine is spread evenly. Once the preparation is complete, remove the residue.

For sore throat due to Cold Damage (a disorder caused by external invasion of cold), hold a date-stone-sized amount of the medicine in the mouth three times a day. When applying it, keep it away from the eyes.

Fourth: Powder for Inducing Sweating (Formula)

Green Powder for Inducing Sweating in Miasmatic Regions: Treats Cold Damage with a flushed complexion, aversion to cold, fever, headache, stiffness of the neck, and body aches.

One and a half liang of ephedra; one liang each of platycodon, asarum, evodia, saposhnikovia, and atractylodes; and one liang and six zhu each of aconite, dried ginger, Sichuan pepper, and cinnamon bark.

Grind the ten ingredients into a fine powder. Take one square-inch spoonful (the amount held by an ancient medicinal spoon) with warm wine, then keep the body warm to induce sweating. Stop taking the medicine once sweating begins. If there is no sweat, only slight sweating, or no relief, take another dose in the same way. If sufficient sweating occurs but the illness remains as before, with headache and fever still present, this indicates excess pathogenic factors within the body; take “Rapid Fermented-Bean Pill” or “Huo’s Pill.” If the bowels move after taking it but the head still feels heavy, place about two soybean-sized portions of the powder in the nostrils. Once the nasal passages feel dry and discharge begins, this may be done three or four times a day. The original text says this will bring recovery and can also prevent seasonal diseases (epidemic illnesses).

Five-Ingredient Powder of Five Ling: Treats delirious speech, restlessness, confusion, and incoherent speech during an epidemic febrile illness.

Eighteen zhu each of polyporus, atractylodes, and poria; twelve zhu of cinnamon bark; and thirty zhu of alisma.

Grind the five ingredients into a fine powder. Take one square-inch spoonful with water three times a day, and drink plenty of water. Recovery follows once sweating occurs.

Cui Wenxing’s Powder for Resolving Illness: Treats seasonal epidemic disorders and fever due to Cold Damage.

Four liang each of platycodon and asarum, eight liang of atractylodes, and one jin of aconite.

Grind the four ingredients into a fine powder. If you contract Cold Damage, take five to seven qian (an ancient measure whose precise modern equivalent is unclear), cover yourself well with a quilt, and induce sweating for relief. If there is no effect, increase the dose slightly until an effect appears. For seasonal epidemic disorders, take five to seven qian in the morning to ward off harmful influences; before visiting someone who is ill, take one dose. Use wine to take the powder in all these cases.

Six-Ingredient Green Powder: Treats Cold Damage with a flushed complexion and aversion to cold.

One liang and six zhu each of aconite and atractylodes; one liang and eighteen zhu each of saposhnikovia and asarum; and three liang and eighteen zhu each of platycodon and aconite.

Grind the six ingredients into a fine powder. Take five to seven qian with warm wine; if there is no effect, gradually increase the dose.

If sweating has not begun after the time it takes to eat a meal, drink another cup of warm rice gruel to help induce sweating. Then keep the body warmly covered, allowing only a slight sweat to appear. Do not let the sweat run continuously, and do not leave the hands or feet exposed. Once the sweating stops, if the sweat has been heavy and continues, dust the body with warm powder; if there has been little sweat, there is no need to use the powder. If no sweating occurs, take another dose. If sweating occurs but the illness has still not cleared, take the Divine Elixir Pill (the formula appears in the next section, under “Sweating Pills”).

Green Powder: Treats Cold Damage in spring, with headache and fever.

Kushen, Houpo, and Shigao (thirty zhu each); Dahuang and Xixin (two liang each); Mahuang (five liang); and Wutou (five pieces).

Grind the seven ingredients into a fine powder. When you feel that you have contracted Cold Damage and have a headache and fever, take one fangcun spoonful (a small medicinal measure) of the powder, mix it with half a sheng of boiled water, warm it in hot water, then strain out the dregs and drink the entire dose. Cover yourself with bedding to induce sweating, and dust the body with warm powder afterward. If you are still not well after some time, take another dose. The medicine may sometimes cause mild diarrhea because the formula contains Dahuang.

Edict-Ordered Whitewei Powder for Inducing Sweat: Treats Cold Damage that has not cleared after three days.

Baiwei, twelve zhu; Xingren and Beimu, eighteen zhu each; Mahuang, one liang and eight zhu.

Grind the four ingredients into a fine powder. Take one fangcun spoonful with wine. Cover yourself with bedding to induce sweating; once you sweat, the illness should clear.

Hua Tuo’s Red Powder: Treats Cold Damage with headache, bodily fever, and stiffness in the lower back and back that pulls on the neck. It is also used for lockjaw caused by pathogenic Wind, recurring bouts of malaria, and symptoms in women after childbirth caused by exposure to Wind-Cold and irregular menstrual Qi, including abdominal distention.

Dansha, twelve zhu; Shujiao, Shuqi, Ganjiang, Xixin, Huangqin, Fangji, Guixin, Fuling, Renshen, Shashen, Jiegeng, Nüwei, and Wutou, eighteen zhu each; Xionghuang, twenty-four zhu; Wuzhuyu, thirty zhu; Mahuang and Daizhe, two and a half liang each.

Grind the eighteen ingredients into a fine powder. Take one fangcun spoonful with wine three times a day. Those who can tolerate the medicine may take two fangcun spoonfuls per dose, then cover themselves with bedding to induce sweating. To treat malaria, take two fangcun spoonfuls about one hour before the attack; adjust the dose as appropriate. Xixin, Ganjiang, Guixin, Dansha, and Xionghuang do not need to be toasted; toast all the other ingredients.

The original uses zhu, liang, and sheng, which are ancient units of weight and volume. Conversion standards varied across periods, so these units have been retained as they appear in the text.

Red Powder is used to treat headache, stiffness of the neck, fever, and pain in the lower back and spine caused by cold damage, when the symptoms recur intermittently. The prescription contains one liang each of dried ginger, fangfeng, sha shen, xi xin, bai zhu, ginseng, Sichuan pepper, fu ling, ma huang, huang qin, dai zhe, jie geng, and wu zhu yu, and two liang of fu zi. Grind these fourteen ingredients into a fine powder. Before meals, take one qian with wine for seven consecutive days.

Aconite Red Powder is used to treat epidemics. The prescription contains one and a half liang of wu tou, half a liang of zao jia, and one liang each of realgar, xi xin, jie geng, and da huang. Grind these six ingredients into a fine powder. Take one dao gui—a small ancient measure of powdered medicine—with clear wine or well water, twice daily. If the condition does not improve, gradually increase the dose until it takes effect. This formula is used for epidemics and may also be used when livestock such as cattle and horses fall ill in an outbreak. On the first day of illness, a person may take one dao gui; alternatively, blow about two soybean-sized portions of the powder into the nostrils.

Water-Resolving Powder is used to treat headache and high fever caused by an epidemic, when the illness has lasted one or two days. The prescription contains two liang each of cinnamon bark, licorice, and da huang, and four liang of ma huang. Grind these four ingredients into a fine powder. The patient should first bathe in warm water mixed from hot and cold water, then take one fangcun bi—a small ancient measuring spoonful of powder—with warm water three times daily. After taking it, cover up to induce sweating; a bowel movement after taking the medicine may also indicate that it is working. Those with a robust constitution may take two fangcun bi. The Yan Nian Mi Lu records a version with two liang each of huang qin and shao yao added. The version in Gu Jin Lu Yan omits licorice and includes shao yao. This formula is used to treat epidemic febrile illness, with painful blisters on the skin, and also to release the muscle layer and induce sweating.

A formula for epidemic illness with severe heat both on the exterior and interior, when the condition is critical: use equal amounts of da huang, han shui shi, mang xiao, shi gao, sheng ma, ma huang, ge gen, and zi ge. Grind the eight ingredients into a fine powder and take one fangcun bi with water twice daily.

Fifth category: Sweating Decoction (using the Gui Zhi pattern as an example)

In general, spring and summer are suitable seasons for inducing sweating. When inducing sweat, the hands, feet, and whole body should become slightly moist with perspiration; ideally, this should continue for a while. The sweat need only moisten the body; it should not pour down in an unbroken stream. If the illness has not yet resolved, sweating may be induced more strongly again. If the patient has already sweated profusely…

Repeated sweating injures Yang Qi and weakens it, so one should not induce sweating over and over. When using a decoction to induce sweating, stop taking it as soon as the condition improves; there is no need to finish the whole dose. When a text says that sweating may be induced but gives no decoction formula, pills or powders may also be used. The key is to judge by whether the condition improves after sweating. Decoctions, however, can be adjusted to suit the pattern and generally make it easier to achieve a better result than pills or powders.

If a person sweats spontaneously without any clear cause, then appropriately inducing further sweating will cure the illness. This is because the defensive Qi (the Qi that circulates at the body’s surface and protects the body) has returned to harmony.

A floating pulse indicates that the pathogenic influence is at the body’s surface and can be released through sweating. Cinnamon Twig Decoction is appropriate.

A floating, large, and rapid Yang pulse (one that beats quickly) can also be treated by inducing sweating; Cinnamon Twig Decoction is appropriate.

A patient who often sweats spontaneously has harmonious nutritive Qi (the Qi that circulates in the vessels). Yet even though the nutritive Qi is harmonious, the pathogenic influence at the body’s surface remains unresolved. This means the defensive Qi is out of harmony. Nutritive Qi circulates within the vessels, while defensive Qi circulates outside them. Induce sweating appropriately to bring the defensive Qi back into harmony, and the illness will resolve. Cinnamon Twig Decoction is appropriate.

When a patient has no other illness of the internal organs but often develops a fever and sweats spontaneously, and the condition does not go away, the cause is disharmony of the defensive Qi. If sweating is induced promptly, before the fever begins, the illness will resolve. Cinnamon Twig Decoction is appropriate.

In Taiyang disease (a pattern of externally contracted illness), fever and sweating indicate that the nutritive Qi is relatively weak and the defensive Qi relatively strong, causing fluids to escape as sweat. Use Cinnamon Twig Decoction to harmonize the nutritive and defensive Qi and dispel Wind.

For Taiyang disease with headache, fever, sweating, and aversion to wind and cold, Cinnamon Twig Decoction is appropriate.

If mild wheezing develops after purging Taiyang disease by mistake, this shows that the pathogenic influence at the body’s surface has not yet been resolved. Cinnamon Twig Decoction with Magnolia Bark and Apricot Kernel is appropriate.

When the exterior pattern of Taiyang disease has not yet resolved, do not use purging. Cinnamon Twig Decoction is appropriate.

If Taiyang disease does not improve after sweating has first been induced and purging is then used, the illness will not resolve if the pulse remains floating. A floating pulse indicates that the pathogenic influence is still at the body’s surface; purging was used instead, so the condition persists. Since the pulse is still floating, the pathogenic influence remains at the surface. The exterior pattern must be resolved for the illness to improve. Cinnamon Twig Decoction is appropriate.

After purging Taiyang disease, if Qi surges upward, Cinnamon Twig Decoction may be taken. If there is no upward surge of Qi, it must not be taken.

Cinnamon Twig Decoction is intended to release the muscles (harmonize the body’s surface and resolve exterior pathogenic influences). Do not use it when the pulse is floating and tight, with fever and no sweating. Keep this in mind to avoid using it incorrectly.

People who drink alcohol regularly should not take Cinnamon Twig Decoction, as it may cause vomiting.

If vomiting occurs after taking Cinnamon Twig Decoction, the patient may later vomit pus and blood.

Cinnamon Twig Decoction treats the Wind-stroke pattern. The Yang position of the pulse is floating, while the Yin position is weak: a floating Yang position indicates fever, and a weak Yin position indicates spontaneous sweating. The patient has a slight aversion to wind, intermittent aversion to cold, and bouts of fever, along with nasal congestion and dry retching. The formula contains Cinnamon Twig, Peony, and Fresh Ginger, three liang each.

Cut or crush the medicinal ingredients, including licorice and jujube. Slice the fresh ginger and break open the jujubes. Add seven sheng of water and boil until the jujubes are soft. Strain out the dregs, then add the remaining ingredients. If there is too little water, add some more. Simmer until it just begins to boil, then take three sheng of the liquid and strain out the dregs. Take one sheng each time, three times a day. Reduce the amount appropriately for children.

If sweating begins soon after the first dose, make the interval before the next dose a little longer. If there is no sweating, shorten the interval as appropriate so the medicine’s effects continue. After sweating begins, follow the prescribed care, especially avoiding exposure to drafts. For more severe illness, take the medicine at night. If one dose brings no relief and the symptoms have not changed, another dose may be taken; sometimes two or three doses are needed before sweating begins and recovery follows. About the time it takes to eat a meal after taking the medicine, drink some hot rice gruel to help the medicine take effect.

Ma Huang Decoction: Used to treat cold damage with headache, lower back pain, pain throughout the body and joints, fever, aversion to cold, absence of sweating, and labored breathing.

Formula: Three liang of ma huang; two liang each of cinnamon bark and licorice; seventy apricot kernels, or fifty if the labored breathing is not severe.

Cut the four ingredients into pieces and add nine sheng of water. Boil the ma huang first. When the water has reduced by two sheng, skim off the foam, then add the remaining ingredients. Boil until two and a half sheng of liquid remain, then strain out the dregs. Take eight he each time, and cover yourself with bedding to bring on sweating.

Da Qinglong Decoction: Used to treat wind strike and cold damage with a floating, tight pulse, fever, aversion to cold, pain throughout the body, absence of sweating, and agitation.

Formula: Six liang of ma huang; two liang each of cinnamon bark and licorice; one piece of gypsum, about the size of an egg and crushed; three liang of fresh ginger; forty apricot kernels; and twelve jujubes.

Cut the seven ingredients into pieces and add nine sheng of water. Boil the ma huang first and skim off the foam, then add the remaining ingredients. Boil until three sheng of liquid remain and divide into three doses of one sheng each. After taking a dose, cover yourself with thick bedding to bring on profuse sweating. Once sweating begins, pat the body with warm powder to stop it. Do not take another dose, as this may cause tendons and muscles to twitch or muscles to jerk, signs that the medicine has been used improperly. Take another dose only if sweating has still not begun.

Yang Poison Shengma Decoction: Used when cold damage turns into yang poison after one or two days, or when yang poison develops after taking medicine, inducing vomiting, or purging. Symptoms include heaviness of the body, pain in the lower back and back, agitation and tightness in the chest, mental unrest, incoherent speech, and even running about or seeing ghosts. Vomiting blood or diarrhea may also occur. The pulse is floating, large, and rapid; red markings appear on the face like embroidered brocade; the throat is sore, and pus and blood are brought up. The text goes on to say that within five days, this illness can…

Prescription for When the Illness Has Reached the Seventh Day and Can No Longer Be Treated

Use half an ounce each of Cimicifuga and licorice, and six zhu each of Chinese angelica, Sichuan pepper, realgar, and cassia bark.

Cut the six ingredients into small pieces. Simmer them in five sheng of water until two and a half sheng remain, then divide into three doses. After each dose, wait about as long as it takes to walk five li before taking the next. After taking the medicine, cover the body warmly so that the hands and feet grow warm. If the pathogenic toxin is expelled and sweating occurs, the illness will ease. If it has not eased, take another dose. Vomiting after taking the medicine is also considered a good sign. (Zhongjing’s prescription)

Another account records that this prescription omits cassia bark and adds a piece of soft-shelled turtle shell about the size of a palm. The accounts in the Zhouhou Fang and the Qianjin Fang are the same. The Gujin Luoyan records adding six zhu of gardenia and a piece of soft-shelled turtle shell about the size of a palm.

Licorice Decoction for Yin Toxin: Used to treat cases in which an external cold disease develops into Yin toxin after only one or two days, or turns into Yin toxin around the tenth day after six or seven days or more of taking medicine. The patient feels heavy, with a stiff back, cramping abdominal pain, and an obstructed throat. When the pathogenic toxin attacks the heart, the area below the heart becomes hard, breathing is short and difficult, and vomiting may occur; the lips turn blue, the face darkens, and the limbs grow cold. The pulse is deep, fine, tight, and rapid. Zhongjing said that these are signs of Yin toxin: the body feels as if it has been beaten. The condition can still be treated on the fifth or sixth day, but by the seventh day it is incurable.

Use half an ounce each of licorice and Cimicifuga, six zhu each of Chinese angelica and Sichuan pepper, and one ounce of soft-shelled turtle shell.

Cut the five ingredients into small pieces. Simmer them in five sheng of water until two and a half sheng remain, then divide into three doses. After each dose, wait about as long as it takes to walk five li before taking the next. Cover the body warmly to induce sweating. The pathogenic toxin should be expelled with the sweat, and the illness will improve once sweating occurs. If there is no sweating, the illness cannot be resolved, so another dose may be taken. (Zhongjing’s prescription; another version omits Sichuan pepper.)

The liang and zhu mentioned here are ancient units of weight. In these prescriptions, “toxin” is the term used in ancient medical texts for pathogenic influences. The original describes ancient methods of diagnosing and treating Yin-pattern illness associated with cold damage.

Yindan Decoction: Used to treat cold damage with pain in the limbs and joints, internal cold accompanied by heat on the body’s surface, and restlessness in the heart.

Use two ounces each of peony and licorice, three ounces each of dried ginger and skullcap, four ounces of cassia bark, and fifteen jujubes.

Cut the six ingredients into small pieces. Simmer them in one dou of water until five sheng remain, then strain out the herbs. Take one sheng warm at a time. Take three doses during the day and two at night, inducing slight sweating.

Yangdan Decoction: Used to treat cold damage with wind strike, marked by a floating pulse and fever, alternating fever and chills, sweating, aversion to wind, stiffness of the head and neck, noisy breathing through the nose, and dry retching. Cinnamon Twig Decoction is the principal formula; ingredients may be added or removed according to the condition, as described below.

Simmer the ingredients in one dou of spring water until four sheng remain. Divide into doses of one sheng each and take three times a day.

For spontaneous sweating (sweating that occurs without inducing perspiration), remove cinnamon twig and add one aconite tuber. For thirst, remove cinnamon twig and add three liang of Trichosanthes fruit. If the bowels are moving freely, remove peony root and cinnamon twig, and add three liang of dried ginger and one prepared aconite tuber. For palpitations below the heart, remove peony root and add four liang of poria. In cases of taxation damage with cramping and tightness in the abdomen, the indicated prescription is Correct Yang Dawn Decoction. After simmering down to two sheng, add half a jin of maltose and divide into two doses. If the pulse is floating and tight and there is fever, this prescription must not be taken.

Six-Ingredient Muscle-Relieving Decoction: Treats fever and bodily pain caused by cold damage.

Four liang of kudzu root; three liang of poria; two liang each of ephedra, oyster shell, and fresh ginger; and one liang of licorice.

Cut the six ingredients into pieces and simmer them in eight sheng of water until two sheng remain. Divide into three doses. If sweating occurs after the second dose and the sweat flows freely, stop taking the medicine. The prescription recorded in Collected Proven Prescriptions from Ancient and Modern Times contains no fresh ginger or licorice.

Muscle-Relieving Decoction: Treats cold damage and warm disease.

Four liang of kudzu root; three liang of ephedra; two liang each of scutellaria root, peony root, and licorice; and twelve jujubes.

Cut the six ingredients into pieces and simmer them in one dou of water until two sheng remain. Take one sheng per dose, three times a day. If there is no improvement after three or four days, the medicine may be taken again to induce sweating if the pulse is floating. If the pulse is deep and forceful, take Kuai Chi Pill to purge. The prescription recorded in Secret Record of Prolonging the Years also contains one liang of cinnamon bark.

A prescription for seasonal epidemics with cold damage, pain, high fever, and a vigorous pulse, when symptoms began one or two days earlier:

One liang of cinnabar, ground to a powder. Simmer it in one dou of water until one sheng remains. Take the whole dose at once, cover yourself with a quilt, and induce sweating.

A prescription for epidemic Qi and cold damage that have not eased within three days:

One sheng of superior fermented soybeans, wrapped in cotton cloth; one sheng of chopped scallion whites; and three sheng of a young boy’s urine.

First stir-fry the fermented soybeans and scallion whites together until blended. Then pour them into the urine and simmer until two sheng remain. Divide into two doses and sip slowly. Cover the body to induce sweating. The original text calls this prescription “divinely effective,” meaning that its effects are remarkable.

Muscle-Relieving Cimicifuga Decoction: Treats seasonal epidemic illness that has not eased after three or four days.

One liang each of cimicifuga, peony root, gypsum, ephedra, and licorice; thirty apricot kernels; and three cowrie shells (another version gives eighteen zhu of fritillaria bulb).

Cut the seven ingredients into pieces and simmer them in three sheng of water until one sheng remains. Take the entire dose warm.

If perspiration is induced again after cold damage, the illness will be cured.

Kudzu and Gentian Decoction

Kudzu and Gentian Decoction is used when cold damage has not improved after three or four days and the body feels feverish and uncomfortable.

The prescription is: eight liang of kudzu root; half a liang each of gentian and greater blue; one liang each of cimicifuga, gypsum, and fragrant solomon’s seal; two liang each of licorice, cinnamon bark, peony, skullcap, and ephedra; and three liang of fresh ginger.

Cut up the twelve ingredients. First boil the kudzu root in one dou of water until eight sheng remain. Add the other ingredients and continue boiling until three sheng remain. Divide into four doses: take three doses during the day and one at night.

Gardenia and Fermented Soybean Decoction

This is used for cold damage lasting four or five days, accompanied by headache, high fever, painful restlessness in the limbs, and inability to eat.

The prescription is: half a liang each of gardenia seeds, coptis, phellodendron, and rhubarb; one sheng of good fermented soybeans; and seven stalks of white scallion.

Cut up the first four ingredients and boil them in eight sheng of water for six or seven boils. Add the white scallion and fermented soybeans, then boil until three sheng remain. Take one sheng per dose, three times a day.

After taking the decoction, keep the body warm and covered to bring on perspiration. Once perspiration appears, wipe the body dry and do not take more medicine to induce sweating. If there is no perspiration, take another dose to strengthen the effect. This prescription has no restrictions on its use and is especially suitable for older people and children. It is highly effective.

Seven-Ingredient Coptis Decoction

Seven-Ingredient Coptis Decoction is used for summer cold damage accompanied by painful restlessness in the limbs, fever, irritability, vomiting, and distension and fullness in the chest and abdomen. In severe cases, the patient may feel as though spirits are troubling them. This results from cold and heat contending within the body and can readily cause irritability.

The prescription is: eighteen zhu each of coptis, poria, and skullcap; one liang each of peony and kudzu root; one liang and six zhu of licorice; and three he of wheat.

Cut up the ingredients and boil them in seven sheng of water until three sheng remain. Let the decoction cool and divide it into three doses. If the patient cannot drink a full sheng at once, give it in small amounts over several occasions. Once the medicine has settled the symptoms, have the patient lie down and rest. This medicine treats pathogenic toxins within the body. If, after taking it, the patient feels heat in the chest or pain in the throat, these symptoms will ease. On the following day, prepare and take another dose in the same way.

This decoction is non-toxic. It can clear heat, direct Qi downward, and calm the patient. For a child, use one-third of the adult dose, boil it in four sheng of water until two sheng remain, and give it in small amounts over several occasions.

Three-Seven Decoction

Three-Seven Decoction is used when, from the third through the seventh or eighth day after cold damage or windstroke, the illness has still not…

A formula for pain in the chest and flanks, cold limbs, dry retching, inability to drink water or other liquids, undigested food lodged in the abdomen, and severe bloody diarrhea occurring dozens of times a day:

Poria (as large as an egg), Scutellaria, and ginseng, three liang each; trichosanthes root, four liang; mirabilite and dried rehmannia, one sheng each; rhubarb, ephedra, and cold water stone, half a jin each.

Pound and sift the nine ingredients, then mix them thoroughly. Take three fangcun bi of the powder—a dose measured with an ancient scoop for powdered medicines—and boil it in one sheng of water until it has boiled three times. Strain out the residue and drink it warm three times a day. Cover yourself with a quilt and induce sweating; the text says this should bring recovery. For severe cases, the original reads “give six-seven-seven.” The wording is likely corrupt and cannot be reliably interpreted.

Wangxiang Ephedra Decoction, for sudden swelling after an externally contracted cold: the swelling may affect the limbs, chest, or back, and may be soft and puffy, as though inflated with air. It may also appear on the face, lips, or neck. In severe cases, the swelling may be concentrated in the lower legs, bulging outward until they are as thick as an axle, yet without pain or redness. Swelling of the limbs may make movement difficult. The text says this formula is suited to these conditions.

Musk, half a liang; frankincense and clove, one liang each; agarwood, green costus root, ephedra, siler root, pubescent angelica root, large-leaved curculigo, and licorice, two liang each; Baiwei root and immature bitter orange, two liang each.

Cut the thirteen ingredients into pieces and boil them in nine sheng of water until reduced to three sheng. Divide into three doses and drink. Cover yourself with a quilt and induce sweating; afterward, apply Fangji ointment to the swollen areas.

For cases lasting more than three days in which the medicines described above have brought no improvement and the pulse remains rapid. The text considers this a sign that Yang Qi remains in the channels and has not yet entered the internal organs. The formula is as follows:

Cinnamon twig, Scutellaria, and licorice, two liang each; cimicifuga, kudzu root, and ginger, three liang each; peony, six liang; gypsum, eight liang; gardenia, twenty-seven pieces.

Cut the nine ingredients into pieces and boil them in nine sheng of water until reduced to two sheng and seven ge. Divide into three doses, taken at intervals equivalent to the time needed to travel about ten li. If sweating begins after the first two doses, stop taking the medicine. If there is still no sweat, take the third dose and stop once sweating begins. If sweating still does not occur, remove the gardenia the next day, add two liang of ephedra and a further two sheng of water, then prepare and take the formula in the same way.

Snow Decoction, a formula for treating externally contracted cold:

Ephedra, ten jin; rhubarb, one jin and twelve liang, selecting the golden-yellow kind; apricot kernels, three dou and four sheng. The original text breaks off at this point.

Coarsely chop the three ingredients above. Take five hu and four dou of snow water, place it in a pot on a stove facing east, and soak the ephedra for three nights. Add the rhubarb and stir well, then heat it over mulberry wood until two hu of the medicinal liquid remain. Strain out the dregs. Pour the liquid back into the pot, add the crushed apricot kernels, and continue simmering. When six or seven dou remain, strain out the dregs and pour the liquid into a copper vessel. Add three dou of snow water and stir well, then continue simmering until two dou and four sheng remain. The medicine is then ready.

When the liquid has cooled and set, form it into pills the size of a pellet. To take it, boil five he of plain water three times, crush one pill and stir it into the water, then drink it once it has cooled to a suitable temperature. Sweating will soon follow. If the illness has not yet improved, take another pill. Keep the medicine sealed so its medicinal vapors do not dissipate.